Serum neutrophil elastase as a potential non-invasive biomarker for assessing hepatic fibrosis in chronic hepatitis B patients

The role of neutrophil elastase (NE) in liver fibrosis caused by chronic hepatitis B (CHB) has not been fully clarified. This study sought to measure serum NE concentrations in individuals with CHB and to determine whether NE could serve as a noninvasive indicator for assessing CHB-related hepatic fibrotic changes. The study enrolled 134 individuals with chronic hepatitis B and 50 healthy participants as controls. According to liver stiffness measurement (LSM) results, the CHB cohort was classified into groups with absent or mild fibrosis, significant fibrosis, and cirrhosis. Serum neutrophil elastase concentrations were determined using an ELISA assay. Correlation analyses were applied to examine variables related to serum NE in patients with CHB. In addition, binary logistic regression was used to assess determinants of significant liver fibrosis, while receiver operating characteristic (ROC) curve analysis was performed to determine the diagnostic performance of serum NE in predicting significant hepatic fibrosis. Serum NE was significantly higher in CHB patients than controls ( P < 0.0001) and increased with fibrosis severity ( P < 0.05). NE was positively correlated with LSM, liver enzymes, HBV DNA levels, APRI, and FIB-4 (all P < 0.05), and was an independent risk factor for significant hepatic fibrosis ( P < 0.01). ROC analysis showed NE had moderate diagnostic value, outperforming APRI and FIB-4 in patients aged ≤ 50 years; combining NE with APRI/FIB-4 improved accuracy. Serum NE is elevated in CHB patients, correlates positively with the severity of hepatic fibrosis, and may serve as a promising non-invasive biomarker for CHB-related hepatic fibrosis, especially in younger patients.